GUATEMALA 


AIST    ADDRESS 


DELIVERED  AT  THK  OPKMNH  OK  THK 


CALIFOBNIA  STATE  MEDICAL  SOCIETY, 


APRIL    18,    1883. 


By    the    President,    DR.     L.     C.     LANE. 


M.  ]{.  Heard  &  Co..  Stationers,  424  .)  St.,  Sac. 


GUATEMALA. 


Alb   Address   delivered   at   the   opening  of  the  California 
State  Medical  Society,  April  18,  1883: 


UY    THE    PRESIDENT,    DR.    L.    0.    LANE. 


Believing  the  facts  might  prove  of  interest  to  the  most  of 
you,  and  add  something  to  the  knowledge  of  the  medical 
topography  of  a  region  but  imperfectly  known,  I  herewith 
offer  the  following  observations,  recently  made  during  a  visit 
to  the  Republic  of  Guatemala. 

Guatemala  is  the  most  northern  of  the  live  States  which 
geographically  comprise  the  region  known  as  Central  Amer- 
ica; the  remaining  four  being  Salvador,  Honduras,  Nicaragua 
mid  Costa  Rica.  Guatemala  lies  between  14  and  18  degrees 
of  northern  latitude,  and  hence  it  is  situated  wholly  in  the 
tropics.  Besides,  it  lies  in  the  northern  portion  of  that  sin- 
gular constriction  which  the  hand  of  Nature  has  impressed 
on  a  portion  of  the  equatorial  region  of  the  western  conti- 
nent, presenting  a  varying  breadth  of  from  three  hundred  to 
four  hundred  miles,  between  the  Atlantic  and  Pacific  oceans. 
South  of  Guatemala,  the  constriction  becomes  lessened  in 
space  until,  at  the  Isthmus  of  Darien,  it  is  but  forty-seven 
miles  wide.  All  old  Californians  remember  the  Isthmus,  and 
carry  in  memory  an  unfading  picture  of  a  journey  across  it; 


570366 


K  MJ-;MJCAL  SOCIETY. 


and  no  matter  how  many  shadows  departing  years  may  cast 
over  us,  this  picture  hangs  untarnished  in  the  background  of 
our  lives,  and  as  we  turn  again  to  it, 

"  Where  o'er  hill  and  valley  plays 
The  sunlight  of  our  early  days," 

I  am  sure  there  is  awakened  in  each  of  our  hearts  an  inde- 
finable thrill  of  pleasure. 

For  recreation,  as  well  as  to  escape  the  unpleasant  season 
of  mid-winter  in  San  Francisco,  on  the  30th  day  of  last 
December,  accompanied  by  my  wife,  I  embarked  on  board 
the  steamer  Granada,  for  Central  America.  Bi-monthly 
trips  are  made  thither  by  vessels  of  the  Pacific  Mail  Steam- 
ship Company.  These  vessels  touch  at  two  Mexican  ports 
and  four  in  Central  America,  finally  arriving  at  Panama; 
thence  they  connect  with  a  line  on  the  Atlantic  side,  so  that 
in  this  way  the  passage  can  be  made  from  San  Francisco  to 
'New  York,  the  whole  journey  being  made  in  about  one 
month.  On  boarding  the  Granada,  I  was  struck  with  the 
wonderful  difference  in  the  accommodations  of  the  present 
steamers  and  those  of  former  times.  The  demands  of  com- 
merce have  banished  from  use  the  magnificent  side- wheel 
steamers,  so  well  remembered  by  all  who  made  this  trip 
twenty  years  ago.  Instead  of  a  floating  palace,  where  all 
was  arranged  to  afford  the  highest  comfort  and  luxury  to  the 
traveler,  we  were  ushered  aboard  a  screw-propeller,  where 
state-rooms  are  narrowed  to  petty  closet-like  -quarters. 
Though  these  steamers  are  more  comfortable  than  the  famous 
Cunarders  that  cross  the  Atlantic,  still  they  have  but  little  to 
remind  one  of  the  sumptuous  quarters  which  once  floated  on 
these  waters,  and  still  less  to  alter  the  definition  which  Dr. 
Johnson  gave  of  a  sea  voyage,  "imprisonment,  with  the 
chances  of  being  drowned  superadded."  Though  the  voyage 
has  been  bereft  of  many  of  its  olden  attractions,  still  there 


AL   ADDRKSS. 


arc  some  persons  in  whom  the  desire  to  hasten  in  life's  fever- 
is!  i  struggle  is  so  far  absent  that  they  prefer  this  way  of 
reaching  New  York.  It  were  well  that  more  of  our  care- 
worn business  men  would  take  this  journey  when  they  re- 
turn to  their  old  homes  in  the  East;  they  would  thus  slow 
the  hand  that  is  measuring  off  the  hours  on  the  dial  plate  of 
their  lives. 

Though  our  departure  was  in  the  season  when  storms 
usually  lash  our  coast,  still  our  steamer  floated  out  through 
tin;  Golden  Gate  in  as  smooth  a  sea  as  the  most  solicitous 
sea  traveler  could  wish.  As  if  to  chronicle  the  approaching 
conclusion  of  1882,  the  hour  of  sailing  was  shifted  from 
morning  till  late  in  the  evening;  so  that  before  we  had 
readied  the  ocean  outside,  the  sun  was  sinking  in  the  watery 
horizon,  and  casting  its  last  rays  on  the  retiring  city  and  the 
magnificent  coast  range  of  mountains  which  lie  at  the  en- 
trance of  the  Golden  Gate,  and  farther  beyond  encircle  our 
Bay.  Around  Tamalpais  floated  those  fleecy  clouds  which 
are  so  characteristic  a  feature  of  the  landscape,  and  which  as 
"  phantom  ships  "  have  been  so  eloquently  described  by  Pol- 
lock, one  of  California's  most  gifted  verse  writers.  How 
many  argonautic  adventurers  of  every  profession  and  grade 
of  humanity,  including  even  the  talented  Pollock  himself, 
after  all  their  struggles  in  our  new  State,  have  in  the  end 
grasped  nothing  but  gilded  clouds,  which  proved  cold  and 
empty  forms  of  bitter  disappointment! 

The  ocean  that  received  us  with  so  placid  a  face,  in  less 
than  twenty-four  hours  assumed  his  proper  wintry  dress,  and 
during  the  remainder  of  the  voyage  treated  us  to  continu- 
ously rough  weather,  and  on  one  occasion  to  a  violent  storm. 

Most  persons  who  have  gone  to  sea,  afterwards  have  their 
storm-story  to  tell;  and  as  the  stories  are  much  alike,  I  will 
omit  the  narration  of  mine,  except  to  state  that  it  was  en- 


STATE  MEDICAL  SOCIETY. 


countered  in  crossing  the  Gulf  of  Tehuantepec,  which  seems 
to  be  one  of  Nature's  great  blow-pipes,  through  which  is  ex- 
pelled from  the  interior  of  Mexico  a  huge  blast  of  wind  that 
reaches  far  out  into  the  Pacific  Ocean.  This  region  is  so  no- 

o 

toriously  the  site  of  storms  that  every  traveler  who  makes 
this  voyage  learns  the  fact  from  some  older  voyager  long  be- 
fore he  reaches  the  place.  From  the  mild  blow  that  is  gen- 
erally experienced  in  crossing  the  outlet  of  the  Gulf  of  Cali- 
fornia, and  the  still  severer  one  at  the  Gulf  of  Tehuantepec, 
it  would  seem  that  Nature  has  a  special  love  for  blowing  over 
a  tongue  of  water  that  projects  into  the  land. 

The  storm  off  Tehuantepec  tested  the  bottom  of  our 
steamer,  as  well  as  that  of  every  passenger's  stomach;  the 
former  lost  none  of  her  cargo — of  the  latter  so  much  cannot 
be  said.  For  over  one  hour,  while  the  steamer  was  running 
before  the  storm,  two  sharks  kept  near  her  keel;  whether 
these  heterocercal  monsters  snuffed  a  bouquet  ahead,  or 
whether  idle  curiosity  impelled  and  sustained  their  diligence, 
remained  an  unsolved  problem,  yet  they  did  prove  one  thing: 
that  muscle  and  tin  can  make  as  much  progress  in  water  as 
steam.  Another  observation  made  was  that  the  phosphores- 
cent agent  in  a  calm,  when  the  water  is  moved  diffuses  itself 
like  liquid  lire— but  during  this  storm  the  luminous  principle 
seemed  to  aggregate  itself  in  isolated  centers,  so  that  the 
amount  of  light  emitted  was  lessened. 

In  HyrtPs  Topographical  Anatomy — a  book  in  which  the 
student  will  learn  much  anatomy  and  be  entertained  with 
much  that  is  witty,  quaint  and  sparkling — the  author  tells  us 
how,  in  crossing  the  Mediterranean  Sea,  he  spent  his  time  in 
studying  the  action  of  the  abdominal  muscles  in  the  act  of 
vomiting.  If  Ilyrtl  had  been  a  voyager  on  this  passage  and 
shared  the  fate  of  most  of  those  on  board,  I  am  certain  that 
paragraph  in  his  Anatomy  would  not  have  been  written,  since 


ANNUAL  ADDRESS. 


both  his  head  and   his  stomach  would   soon  have  been  empty. 

Many  attempts  have  been  made  to  offer  a  scientific  expla- 
nation of  sea-sickness;  to  the  numerous  ones  found  among 
medical  writers,  I  will  add  one  more: 

In  the  last  few  years  the  German  cerebro-viyisectionists 
have  plainly  demonstrated  that  in  many  instances  of  cerebral 
trouble  the  cardinal  condition  is  that  of  anaemia,  instead  of 
hyperamiia,  as  was  formerly  taught,  and  as  the  concomitant 
of  such  anemia,  nausea  may  arise  in  a  perfectly  sound  stom- 
ach. In  intra-cranial  Circulation  two  factors  figure —  the 
movement  of  the  blood  and  the  movement  of  the  cerebro- 
s phial  serum.  The  affluent  blood-wave  displaces  and  causes 
the  serum  to  escape  from  the  skull;  the  returning  blood-wave 
again  acts  reversely,  and,  as  it  escapes,  it- is  replaced  by  the 
entering  cerebro-spinal  serum.  Such  efflux  and  reflux  of  the 
serum  can  be  seen  in  the  animal's  neck,  when  the  occipito. 
atloid  ligaments  are  laid  bare.  The  ascent  and  descent  of  the 
subject  on  shipboard  tend  to  interrupt  the  uniform  move- 
ment of  the  reciprocal  currents — both  by  virtue  of  their  in- 
ertia sink  as  the  vessel  rises,  and  rise  as  the  vessel  sinks; 
thence  arises  disturbance  in  the  equilibrium  of  the  supply  of 
blood  to  the  brain,  and,  as  a  further  consequence,  sympathetic 
nausea.  Long  continuance  of  the  cause  finally  begets  a  tol- 
erance, and  hence  a  disappearance  of  the  sea-sickness.  Should 
this  explanation  share  the  fate  of  its  predecessors,  and  requ  i  re 
that  non  sequitur  should  be  appended  to  it,  let  the  discoverer 
of  the  fallacy  refrain  from  concluding, propter  inscitiam  pro' 
priain — (lack  of  individual  experience.) 

To  get  relief,  or  in  a  measure  to  avoid  sea-sickness,  secure 
a  berth  "  amidships,1'  and  during  rough  weather  maintain  the 
horizontal  position,  use  a  light  and  easily  digested  diet  in 
which  there  is  no  excess  of  liquids,  and  remain  in  bed  during 
the  period  requisite  for  digestion.  As  constipation  sooner  or 


STATE  MEDICAL  SOCIETY. 


later  occurs,  this  should  be  relieved  by  proper  remedies;  and 
this  latter  hint  should  especially  be  attended  to  at  the  end  of 
a  protracted  voyage  where  there  has  been  a  transition  from  a 
cold  to  a  hot  climate.  This  little  precaution,  and  especially 
if  the  traveler  will^  take  old  Rush's  "  ten  and  ten  "  of  submu- 
riate  and  jalap,  will  often  ward  off  an  attack  of  fever.  Sea- 
sickness, depending  as  it  does  upon  causes  outside  of  the 
body,  is  not  curable  by  any  internal  remedy.  Chapman's 
ice-bag,  with  which  many  English  travelers  provide  them- 
selves when  they  cross  the  Channel,  i^trite  of  amyl,  the  bro- 
mides, etc.,  are  all  useless  ballast  in  a  sea  voyage. 
The  lines  of  Byron— 

"Of  all  the  seas  the  traveler  pukes  in, 
None  is  more  dangerous  than  the  Euxine," 

plainly  point  to  the  universality  of  sea-sickness;  and  he  who 
travels  by  sea  may  safely  include  this  in  the  expenses  which 
he  must  incur  in  order  to  see  other  lands,  for  none  are  exempt 
except  a  favored  few- — very  few — in  whom  the  partial  hand 
of  nature  has  so  cunningly  adjusted  the  elements  of  the  cere- 
bral circulation  that  they  never  get  adrift,  but  remain  chock-a- 
block  during  wind  and  storm. 

During  our  progress  southward  we  were  generally  in  view 
of  land;  the  western  coast  of  Mexico,  consisting  of  hills  and 
low  mountains  that  were  nearly  destitute  of  trees  and  living 
vegetation,  made  a  landscape  of  which  the  eye  seldom  grew 
weary.  And  this  view  became  doubly  interesting  when  it 
reminded  one,  as  was  often  the  case,  of  the  Coast  Range  of 
mountains  of  our  own  State,  and  recalled  those  picturesque 
lines  of  beauty  which  nature  has  so  happily  traced  in  the 
face  of  California.  As  in  art,  one  finds  different  schools  with 
distinctly  characteristic  methods  and  styles,  so  in  sketching 
mountain  forms,  uniformity  has  not  fettered  the  hand  of  na- 
ture; such  liberty  she  indulged  in  while  tracing  our  coast 


AN  NT  A  I-     A'DDUKSS. 


mountains  and  foothills,  developing  a  style  elegant,  distinc- 
tive and  peculiar.  The  mountain  of  Norway  with  its  som- 
bre brow  of  pines  mirrored  in  the  lake  at  its  foot,  and  the 
Alpine  peak  with  the  green  meadow  at  its  base  bestarred 
with  yellow  flowers,  have  each  their  special  charm — yet  the 
traveler  who  has  not  seen  the  mountains  of  California  has 
yet  in  store  for  himself  a  pleasure  which  the  former  can 
never  awaken  in  his  heart.  And  this  same  originality  of 
character  is  found  from  the  Columbia  River  to  the  tropical 
region  of  Mexico,  reappearing  again,  as  I  have  seen  in  the 
Andes  of  Peru.  Hence  the  Sierras,  the  Cordilleras  and  the 
Andes  are  one  and  the  same  sketch  made  by  the  hand  of  Na- 
ture— a  sketch  in  which  the  devices  of  concealment  with 
which  Art  often  disguises  her  defects  are  rigidly  avoided,  since 
each  outline  is  distinctly  traced  on  the  sky,  and  is  as  clearly 
visible  as  if  seen  in  a  miniature  picture  held  in  the  observer's 
hand. 

On  the  eleventh  day  of  our  voyage  we  arrived  at  Cham- 
perico,  a  small  port  on  the  coast  of  Guatemala.  Champerico 
has  commercial  importance  on  account  of  the  large  amount 
of  coffee  produced  in  its  vicinity  and  thence  shipped.  From 
this  point  the  two  distinctive  physical  characteristics  of  the 
State  of  Guatemala  become  plainly  visible,  viz:  high  lands 
and  low  lands.  The  low  lands  comprise  a  highly  fertile  belt 
of  soil  that  reaches  some  thirty  miles  inland  from  the  Atlantic 
and  the  Pacific;  between  these  level  plains  lies  the  high  land, 
which  rises  here  and  there  .in  to  mountains  of  high  altitude. 
The  greatest  elevation  reached  is  between  two  and  three  miles 
above  the  sea  level.  Among  the  summits  that  especially  at- 
tract notice  are  those  of  Santa  Maria,  El  Agua  and  El  Fuego, 
the  latter  two  being  volcanoes  which  have  not  lost  their  func- 
tion of  occasionally  disgorging  their  tiery  contents. 

During  our  stay  at  Champerico  several  of  the  travelers 


STATE  MEDICAL  SOCIETY. 


were  entertained  by  an  excursion  upon  a  short  portion  of  the 
railroad  that  is  being  constructed  from  the  port  to  a  town 
which  is  situated  about  thirty  miles  inland,  and  when  finished 
will  serve  as  an  outlet  to  the  immense  crop  of  coffee  grown 
in  that  region.  The  passengers  who  enjoyed  this  short  ride 
were  quite  carried  away  in  their  transports  of  wonder  at  the 
tropical  scenes  which  wrere  thus  suddenly  opened  to  their 
view;  and  I  am  sure  that  each  one  bears  with  him  many  kind 
remembrances  of  the  hospitalities  of  Captain  Douglass  and 
others  who  are  managing  the  construction  of  this  road,  which 
is  being  built  by  the  money  and  enterprise  of  a  San  Fran- 
cisco company. 

From  Champerico,  a  few  hours  steaming  brought  us  to  Sail 
Jose,  the  leading  port  on  the  western  coast  of  Guatemala. 
Here,  as  the  early  morning  opened,  we  found  ourselves  lying 
almost  in  the  shadows  of  the  volcanos,  "Water  and  Fire,  which, 
though  some  miles  inland,  seemed  very  near,  owing  to  the 
clearness  of  the  air.  From  the  nostrils  of  El  Fuego  (fire)  a 
cloud  of  white  vapor  was  slowly  escaping  and  idly  wreathed, 
like  grey  locks,  this  slumbering  Titan's  head.  As  he  lay 
there  in  his  placid  sleep  no  one  would  have  thought  that  in 
that  quiet  form  were  concealed  the  earthquake  and  Force  and 
Might,  more  than  a  match  for  Promethean  divinity. 

The  tumult  and  bustle  consequent  upon  disembarking  are 
illy  consonant  with  the  musing  which  otherwise  such  a  morn- 
ing and  such  scenery  might  have  favored;  thoughts  of  a  mo  re 
practical  nature  occupied  our  minds,  viz.  to  go  ashore  and 
see  that  none  of  our  effects  were  left  behind.  From'  the 
steamer  we  were  carried  in  barges  to  the  end  of  a  long  iron 
pier,  which  has  been  built  from  the  shore  into  the  water  about 
one-eighth  of  a  mile. 

To  digress  here.  Nature  has  been  very  unequal  in  her 
gifts  to  the  eastern  and  the  western  sides  of  the  continent. 


ANNTAL  ADDRESS.  9 


The  eastern  coast  has  been  favored  with  well  sheltered  har- 
bors -great  pockets,  as  it  were,  inviting  commerce  to  shelter 
there  its  stores.  The  Pacific  side,  on  the  contrary,  is  remark- 
ably wanting  in  such  resources.  Any  one  who  has  easily 
walked  on  or  off  a  vessel  lying  at  one  of  the  wharves  of  San 
Francisco,  and  who  debarks  at  a  Mexican,  Central  American, 
or  South  American  port,  in  a  small  boat  that  is  compelled  to 
land  on  a  harhorless,  unprotected  beach,  has  learned  that  our 
land-locked  bay  is  a  natural  gift  beyond  all  price.  And  these 
advantages  will  take  a  still  higher  rank,  if  he  should  ever 
land  at  San  Jose  de  Guatemala,  where  the  debarkation  is  done 
in  a  basket  that  is  suspended  to  a  crane  some  twenty  feet 
above.  The  hoisting  of  the  basket  and  its  swinging  shore- 
wards  are  done  by  steam.  The  tossing  of  the  small  boat 
which  carries  him  to  the  pier,  and  the  swaying  revolutions  of 
the  balloon-like  basket,  for  the  first  hour  of  his  advent,  will 
quite  absorb  his  attention. 

Among  the  fellow  passengers  during  the  voyage  was  Gen- 
eral Butterfield,  a  man  well  known  in  the  history  of  our 
country  as  a  fearless  champion  of  the  cause  of  our  Govern- 
ment during  the  late  war.  His  present  mission  hither  was 
as  the  representative  of,  and  shareholder  in,  an  American 
company  that  has  purchased  the  control  of  a  railroad  which 
has  lately  been  constructed  from  San  Jose  to  Escuintla,  a 
town  nearly  thirty  miles  inland.  General  Butterfield,  accom- 
panied by  Mr.  George  Crocker,  son  of  the  well  known  capi- 
talist of  San  Francisco,  came  for  the  purpose  of  completing 
this  road  to  Guatemala  City,  the  point  of  its  final  destination. 
Besides  this  work,  they  are  now  occupied  in  making  topo- 
graphical surveys  preliminary  to  building  other  railroads  in 
Guatemala,  and  the  adjacent  State  of  Salvador.  The  great 
energy,  unusual  powers  of  endurance,  experience  in  the  field, 
and  personal  ability  of  General  Butterfield,  and  above  all,  his 


10  STATE  MEDICAL  SOCIETY. 

self-denying  devotion  to  the  enterprise  which  has  been  dele- 
gated to  him,  shows  that  Northern  capital  has  exercised  keen 
discretion  in  the  selection  of  its  management;  and  if  a  pre- 
diction be  allowed,  it  requires  no  special  acumen  to  discover 
that  the  hand  which  led  martial  hosts  to  success  in  war,  will 
conduct  peaceful  legions  here  to  no  less  signal  victories  in 
their  battles  with  tropical  nature. 

On  arriving  at  San  Jose,  General  Butterfield  invited  a 
number  of  the  passengers  to  accompany  him  in  an  excursion 
from  the  port  to  Escuintla,  the  present  terminus  of  the  road. 
The  strange  novelty  of  the  tropical  flora  of  the  country  trav- 
ersed by  the  road,  many  of  the  shrubs  and  trees  being  in 
bloom,  and  others  being  quite  covered  with  the  rich  flowers 
of  the  trailing  convolvulus,  was  one  of  those  rare  spectacles 
which  falls  on  the  traveler  as  a  new  revelation,  that  remains 
as  an  unfading  picture  forever  afterwards,  giving  delight  as 
often  as  the  hand  of  memory  unveils  it.  In  that  panoramic 
scene  which  was  rapidly  unfolded  to  view,  as  the  train  sped 
on  its  course,  were  now  and  then  caught  glimpses  of  fields  of 
coffee  and  sugar  cane,  and  of  the  thatched  huts  of  the  Indians, 
under  the  shade  of  cocoa  palms  and  orange  trees.  At.  Es- 
cuintla, the  party  was  the  recipient  of  a  choice  collation,  in 
which  the  wine  of  the  North  mingled  its  gift  with  that  of 
the  passion-flower  and  a  half  dozen  other  tropical  fruits. 
This  finished,  the  party  next  visited  a  church  built  over  two 
hundred  years  ago,  and  ascending  its  half -ruined  tower,  looked 
on  one  of  the  most  beautiful  landscapes  of  Guatemala — a 
scene  which  the  artist's  pencil,  not  written  words,  can  por- 
tray. Thirty  miles  away  lay  the  Pacific,  of  which  the  mov- 
ing waters,  mirror-like,  gave  glimpses  of  reflected  light; 
while  nearer  by,  cloud-shadow  and  sunlight  disputed  domin- 
ion over  vast  scopes  of  evergreen  forests  and  flelds,  whose 
verdure  rejoiced  in  unending  Summer;  on  the  other  side, 


ANNUAL  ADDRESS.  11 


close  at  hand,  rose  the  huge  forms  of  Water  and  Fire,  their 
bases  enriched  with  a  zone  of  forests,  interrupted  now  and 
then  by  cultivated  fields  of  cane  and  coffee  ;  these  green 
fields  could  be  descried  reaching  far  up  toward  the  summit, 
and  seemed  to  hang,  like  emerald  gems,  on  the  mountain's  side. 
In  the  evening,  after  the  rest  of  the  party  had  returned 
aboard,  we  drove  to  the  plantation  of  Concepcioii,  which  lies 
at  the  base  of  the  volcano  of  Agua.  This  large  estate, 
which  is  devoted  to  the  raising  of  sugar  cane,  is  the  property 
of  Baron  Duteil,  who  came  to  Guatemala  many  years  ago. 
This  place,  which  is  in  a  high  state  of  cultivation,  besides  its 
wonderful  natural  endowments,  shows  in  the  rare  felicity  of 
its  improvements  that  its  owner  has  kept  even  pace  with 
nature  ;  for  one  is  surprised  at  the  rare  combination  of  com- 
fort, luxury  and  elegance  which  blend  in  the  appointments 
of  its  manorial  mansion.  From  Escuintla,  there  leads  to  it 
an  excellent  road,  the  latter  portion  of  which  passes  through 
an  alameda  or  avenue  of  cocoa  palms,  bordered  on  each  side 
by  a  broad  expanse  of  sugar  cane,  all  of  which  was  overlooked 
from  the  cool  piazza  of  the  front  of  the  house.  In  the  rear 
was  another  open  piazza  where  meals  were  served,  and  where 
long  vistas  of  field,  forest,  gorge  and  volcano,  took  the  place 
of  the  ordinary  wall  pictures.  A  third  side  looked  on  a 
fountain  of  playing  water  and  on  a  short  avenue  of  trees  that 
ended  near  a  swimming  bath.  This  bath  was  constantly  re- 
plenished by  pure  water  from  a  neighboring  stream,  the 
water  constantly  falling,  cascade-like  into  a  stone  reservoir 
some  thirty  feet  long,  that  was  overarched  by  a  bower  of 
roses  and  passion  flowers;  the  perfume  of  these  flowers,  and 
their  tints  yet  visible  in  the  moonlight,  the  faultless  tempera- 
ture of  both  air  and  water,  made  a  picture  of  oriental  luxury 
such  as  will  recall  to  the  reader's  memory  Irving's  sketches 
of  the  Alhambra, 


12  STATE  MEDICAL  SOCIETY. 

The  amount  of  sugar  produced  at  Concepciou  was  .so  enor- 
mous that  upon  the  item  of  spirits  distilled  from  the  waste 
material  the  government  receives  a  tax  of  over  live  thousand 
dollars  a  month. 

Leaving  Concepcioii  on  the  following  day,  we  next  pro- 
ceeded to  Barcenas,  a  large  coffee  estate  that  lies  somewhat 
off  the  main  road  which  leads  from  Escuintla  to  the  City  of 
Guatemala.  This  place  is  owned  by  Senor  Samayua,  who  is 
the  Minister  of  Agriculture,  and  is  reckoned  among  the 
wealthiest  men  of  Central  America.  Our  late  arrival  pre- 
vented us  from  seeing  much  of  the  estate  that  night,  but 
early  the  next  morning  the  most  of  the  party  were  on  the 
grounds,  eager  and  curious  to  see  growing  coffee.  One  saw 
there  this  precious  shrub  in  every  stage  of  growth,  from  the 
nursery  plants,  which  were  just  peering  through  the  earth, 
under  cover  to  screen  them  from  the  hot  sun,  to  the  full  grown 
shrubs,  some  ten  feet  high,  which  were  laden  witli  nearly  ripe 
fruit.  This  shrub  resembles  somewhat  a  cherry  tree  in  foliage, 
though  the  leaves  are  more  glossy.  The  fruit  grows  in 
crowded  clusters,  without  stems,  in  the  axils  of  the  branches. 
Each  berry,  when  ripe,  is  of  purplish  tint,  and  if  perfect,  it 
contains  two  hemispherical  grains  with  their  flat  faces  op- 
posed. The  pulp  of  these  berries  is  of  a  sweetish  taste,  and 
possesses  none  of  the  qualities  of  coffee.  From  the  growing 
shrub  we  were  next  conducted  by  Mr.  Klee,  the  manager  of 
the  estate,  to  the  mill  where  the  coffee  berries  were  being 
hulled  or  threshed.  During  the  short  time  that  we  regarded 
this  work,  several  hundred  pounds  of  coffee  passed  through 
the  mill.  The  consumer  of  coffee  in  the  North  will  value  his 
cup  still  more  when  he  learns  that  the  annual  product  of  a 
shrub  is  never  over  four  pounds,  and  on  an  average  is  not 
much  more  than  one  pound;  that  the  producing  period  of  a 
shrub  is  not  more  than  fifteen  years;  and  that  each  grain  of 


ADDKKSS.  13 


coffee,  from  planting  until  it  reaches  the  sack,  receives  the 
labor  of  over  a  dozen  persons.  The  coffee  which  commands 
the  highest  price  in  the  market,  known  as  the  pea  coffee,  but 
here  called  u caracolillo,"  from  its  resemblance  to  a  snail 
shell,  is  of  small,  round  form,  like  a  miniature  egg,  and  would 
appear  to  be  a  dwarfed  product,  where  the  berry,  instead  oi' 
two  grains,  contains  but  one  grain. 

From  Barcenas  we  proceeded  to  the  City  of  Guatemala, 
the  first  hour's  ride  being  through  coffee  fields  belonging  to 
the  estate  of  Samayoa.  In  many  places  I  observed  that  the 
shrubs  were  partly  shaded  by  the  plantain  or  banana  shrub. 
After  some  four  hours  ride  we  reached  the  City  of  Guate- 
mala, situated  on  a  large  plain  about  one  mile  above  sea  level. 
On  arriving  here  nearly  all  persons  are  rendered  sensible  of 
the  high  altitude  through  the  increased  demand  made  by  the 
luno-s  for  more  air,  owing  to  the  rarity  of  the  atmosphere. 

The  City  of  Guatemala  was  originally  built  about  thirty 
miles  from  the  present  location,  close  to  the  base  of  the  vol- 
canos,  Water  and  Fire,  and  at  a  slightly  less  elevation  than 
that  of  the  new  city.  The  old  city,  now  named  Antigua,  was 
twice  destroyed  by  the  adjacent  volcanoes — once  in  1541,  and 
again  in  1762.  In  the  first  disaster,  on  a  dark  night  when 
rain  was  rapidly  falling,  there  gushed  forth  a  flood  of  water 
from  one  of  the  mountains,  which  was  quickly  followed  by 
an  eruption  of  lava  from  the  other;  and  these  destructive 
forces  were  soon  reinforced  by  earthquakes,  so  that  the  town 
was  utterly  destroyed,  burying  in  its  ruins  the  families  of 
Alvarado  and  others  of  the  primitive  conquerors.  The  old 
Castilian  conquerors,  shrinking  from  no  peril  and  dismayed 
by  no  disaster,  rebuilt  the  city,  to  suffer  a  similar  fate  from 
earthquakes  two  hundred  and  twenty  years  later. 

A  visit  to  Antigua  shows  the  traveler  a  wonderful  pile  of 
ruins,  surpassing  anything  of  the  kind  to  be  seen  elsewhere 


14  STATE  MEDICAL  SOCIETY. 

in  America.  I  saw  there  the  fallen,  or  half  fallen  walls  of 
over  one  hundred  and  fifty  churches,  of  which  enough  re- 
mained to  show  their  former  greatness.  Walls  cleft  and 
partly  or  wholly  fallen,  fragments  of  broken  columns,  ruined 
arches,  broken  statuary,  fallen  altars,  shrubbery  and  trailing 
vines  disputing  with  mutilated  figures  for  place  in  the  weather 
stained  niches,  and  beasts  stabled  on  floors  where  once  the 
worshiper  knelt,  are  the  characters  in  which  the  earthquake 
and  volcanic  violence  have  left  record  of  their  advent  of  ruin. 

The  country  around  Antigua  is  of  unsurpassed  richness. 
As  in  the  fertile  fields  around  ^Etna  and  Vesuvius — so  here  in 
these  volcanic  crucibles  Nature  has  compounded  a  soil  most 
favorable  to  vegetable  growth;  here  the  coffee  shrub  bends 
under  its  richest  harvest,  and  fruit  trees  so  numerous  that 
their  names  would  fill  a  half  page,  with  slight  toil  offer  their 
luscious  products  to  man;  here  all  plant-life  revels  in  riotous 
luxuriance.  No  wonder  that  in  such  an  Eden  numerous 
warnings  passed  unheeded;  and  only  when  the  demon  of 
destruction  had  converted  the  place  into  one  vast  tomb  did 
the  inhabitants  forsake  this  paradise — and  lest  there  should 
be  a  return  thither,  the  fallen  city  is  more  securely  guarded 
than  if  sentineled  by  a  flaming  sword  turning  every  way  at 
its  gates,  since  not  a  week  passes  there  without  an  earthquake, 
nor  a  day  without  some  tremor,  as  revealed  by  the  sisometer. 

The  present  City  of  Guatemala  contains  sixty  thousand  in- 
habitants, and  is  located  on  a  large  plain  that  is  surrounded  on 
the  east,  north  and  west  by  ranges  of  mountains.  When  the 
city  is  looked  at  from  an  eminence  it  presents  a  very  impos- 
ing appearance,  owing  to  the  wa'lls  of  the  houses  being  of 
snowy  whiteness  and  many  of  the  churches  being  models  of 
architectural  beauty.  The  streets,  crossing  at  right  angles, 
are  of  good  width  and  paved  with  stones  of  two  forms — one 
of  flat  blocks,  placed  at  regular  intervals,  while  the  other, 


ANNUAL  ADDEESS.  15 


smaller  and  more  irregular,  fill  the  spaces  between  the  blocks 
— and  the  whole  is  so  disposed  as  to  slope  towards  the  center 
of  the  street,  there  forming  a  shallow  gutter.  The  sidewalks, 
sloping  towards  the  street,  are  paved  with  square  blocks  of 
stone.  The  city  is  provided  with  a  system  of  sewerage  which, 
though  imperfect,  is  superior  to  that  of  San  Francisco. 

To  digress  to  the  important  topic  of  sewers,  I  would  here 
say,  that  when  abroad  a  few  years  ago,  I  made  a  careful  and 
laborious  examination  of  the  sewerage  system  of  London,  and 
from  the  Board  of  Works  of  that  metropolis  procured  draw- 
ings and  description  of  the  same;  also,  a  description  of  the 
Paris  system;  all  of  which  is  contained  in  a  biennial  report 
of  the  California  State  Board  of  Health.  An  examination 
and  comparison  of  the  system  of  San  Francisco  with  that  of 
London  or  Paris  convicts  us  of  egregious  ignorance  and  stu- 
pidity, and  will  cause  every  lover  of  our  city  to  wish  that  he 
lie  could  blot  out  this  page  from  the  municipal  history  of  San 
Francisco;  yet,  so  long  as  official  position,  votes,  and  sewer 
builders  and  cleaners  are  so  closely  articulated,  so  long  will 
mismanagement  prevail  and  epidemic  pestilence  make  its  re- 
current visitations. 

The  houses  of  Guatemala  are  built  of  adobe,  stone,  or  brick, 
the  walls  being  from  two  to  three  feet  thick,  to  afford  security 
of  Qscape  in  case  of  earthquakes.  To  have  sufficiency  of 
room,  they  must  occupy  much  more  space  than  even  large 
houses  do  with  us.  The  floors  are  made  of  half -burnt  brick, 
resting  on  a  concrete  foundation,  and  are  covered  with  a  thin 
straw  matting.  One  great  pest  of  the  country  is  fleas,  which 
are  not  contined  to  the  untidy  houses  of  the  poor,  but  they 
hold  sway  in  every  household.  While  Nature  has  added  to 
the  size  of  other  insects  in  the  tropics,  she  has  amply  com- 
pensated for  diminished  volume  of  the  flea  by  increased  ac- 
tivity, and,  as  if  to  favor  this  commonweal th  of  insects,  men- 


lb'  STATE  MEDICAL  SOCIETY. 

tha  pulegium  lias  been  omitted  in  the  flora  here.  I  would 
advise  one  of  those  enterprising  Dalmatians  who  are  growing 
flea  powder  in  the  neighborhood  of  Stockton,  California,  to 
come  here  and  plant  the  flea-driving  pyrethrum.  If  he  will 
do  so,  he  will  enrich  himself,  and  win  the  praise  of  this  flea- 
ridden  people. 

The  water  used  here  comes  through  time-worn  and  rickety 
aqueducts,  from  a  natural  fountain,  some  miles  distant. 
Arriving  in  the.  city  it  is  conducted  to  one  or  more  reservoirs 
in  each  block,  which  are  constructed  in  a  corner  or  side  of  a 
house,  in  which  the  rattling  sound  of  the  falling  water  is 
heard,  as  one  passes  near  it.  From  such  a  reservoir,  several 
houses  are  supplied.  The  water,  before  its  use  as  drinking- 
water,  is  caused  to  pa,ss  through  the  porous  wall  of  a  large 
filter  that  is  made  from'tiifa  or  volcanic  rock.  Besides 
cleansing,  this  stone  filter  cools  the  water.  Such  filtration 
might  be  adopted  with  advantage  in  San  Francisco. 

As  public  institutions  for  the  indigent  sick,  one  finds  two 
in  the  City  of  Guatemala,  one  for  soldiers,  and  the  other  for 
civilians.  Through  the  courtesy 'of  Dr.  Joaquin  Yela,  I  was 
enabled  to  see  and  inspect  each;  also  from  his  annual  report 
I  was  able  to  get  much  information  respecting  hospital  man- 
agement here. 

The  Military  Hospital  is  located  on  elevated  ground,  three 
miles  from  the  city.  The  diseases  seen  there  were  those  re- 
sulting in  the  main,  from  dissipation,  the  largest  contingent 
being  furnished  by  the  Guard  of  Honor.  One  found  that 
the  Southern  sons  of  war  are  nearly  akin  to  those  of  the 
North)  in  making  frequent  pilgrimages  to  an  unlawful 
shrine;  and  as  Vulcan  caught  in  a  net  the  war  god  during 
an  unlawful  visit  to  his  own  household,  so  the  followers  of 
Mars  often  re-enact  his  role,  insomuch  that  their  follies  cost 
the  State  as  much  as  their  wounds  in  its  defense.  Hygienic 


ANNUAL  ADDRESS.  17 


philanthropy  lias  here  a  hard  problem  to  solve.  Who  1ms 
the  wisdom  to  do  it? 

A  visit  to  the  Hospital  General  for  civilians  showed  me  an 
institution  as  well  conducted  as  similar  ones  in  the  United 
States.  Disease  here  is  classified  as  internal,  or  medical,  and 
external,  or  surgical;  and  each  of  these  sections  is  under  the 
charge  of  an  intelligent  corps  of  medical  attendants.  The 
whole  number  of  patients  treated  here  during  the  year  1882, 
was  live  thousand  four  hundred  and  ninety  persons;  of  these 
there  remained  on  hand  January  1st,  1883,  two  hundred  and 
forty  patients;  whole  number  of  deaths  in  1882,  four  hundred 
and  thirty-three.  The  medical  and  surgical  service  is  rendered 
gratuitously,  with  the  permission  of  the  service  utilizing  the 
hospital  for  medical  instruction.  Internes,  chosen  by  the  fac- 
ulty of  the  medical  school,  reside  in  the  hospital,  and  to  some 
extent  replace  the  regular  physicians  during  their  absence. 
The  physicians  and  surgeons  attending  the  hospital  are  mainly 
graduates  of  the  Guatemala  school,  who  have  been  abroad 
and  added  to  their  qualifications  by  a  period  of  study  in 
Paris. 

In  the  treatment  of  the  sick,  Dr.  Yela  told  me  that  they 
had  abandoned  the  use  of  stimulants.  This  course  had  been 
adopted  after  a  trial  of  Todd's  mode  of  treatment  by  stimu- 
lation, under  which  it  was  found  that  more  died  than  under 
the  present  non-stimulant  method. 

A  striking  feature  in  the  building  is  that  the  main  portion 
of  it  is  constructed  in  the  form  of  a  Greek  cross;  the  effect 
of  such  an  arrangement  is  singularly  impressive,  as,  standing 
in  the  center  the  eye  wanders  along  the  four  avenues,  each 
lined  with  two  rows  of  beds  for  the  sick.  Suffering  in  its- 
'many  forms  seemed  strikingly  in  place  there,  and  to  re-enact 
the  great  scene  whence  sprang  this  sacred  symbol,  which 
devotion  and  self  sacrifice  have  carried  to  every  clime  and 


18  STATE  MEDICAL  SOCIETY. 

planted  on  every  shore  where  throbs  a  human  heart. 

The  immediate  attendance  upon  the  patients  is  rendered 
by  Sisters  of  Charity;  and  to  this  is  due  the  remarkable 
order,  the  scrupulous  cleanliness  and  the  faultless  system 
which  characterized  the  internal  management  of  this  institu- 
tion. A  large  range  of  observation,  embracing  nearly  all 
parts  of  the  globe,  has  proven  to  me  that  such  management 
is  the  best,  and  it  is  quite  inexplicable  why  the  French 
authorities  have  lately  become  so  hostile  to  it,  and  are  so 
determined  to  abolish  it.  Armand  Despres,  of  resolute  heart 
and  great  readiness  as  a  writer,  firmly  resists  this  change  in 
the  Parisian  hospitals,  and  though  in  the  minority,  he  is 
giving  his  opponents  much  trouble.  Besides  observation 
abroad,  personal  experience  at  home,  wrhile  acting  as  surgeon 
to  a  hospital  in  San  Francisco,  under  the  care  of  the  Sisters 
of  Mercy,  has  fully  proven  to  me  the  excellence  of  this  sys- 
tem, for  one  sees  that  untiring  devotion  to  the  wants  of  the 
sick,  utter  extinction  of  self,  and  final  death  at  the  altar  tit 
which  an  unchangeable  purpose  had  been  pledged,  find  there 
their  fullest  realization. 

The  sources  of  maintenance  of  the  Hospital  General  are 
novel  and  worthy  of  mention.  These  are  moneys  derived 
from  the  sale  of  lots  for  the  burial  of  the  dead,  income  from 
bull  tights,  a  lottery  established  for  this  purpose,  a  certain 
percentage  of  bequests  left  by  will,  also  bequests  occasionally 
made  to  the  hospital,  and  a  part  of  the  collections  made  in 
the  churches. 

The  burial  of  the  dead  is  under  public  management,  and 
is  an  expensive  matter,  costing  those  of  average  means  from 
iive  hundred  to  one  thousand  dollars.  The  interments  are 
made  a  few  hours  after  death.  The  body  is  deposited  in  a 
stone  or  brick  receptacle  that  is  on  a  level  with  the  earth, 
while  about  this  there  is  built  a  somewhat  pretentious  inauso- 


A.NM  AI,   ADDRESS.  19 


leuni  of  brick  or  stone  masonry.  And  these  houses  for  the 
dead  are  of  such  uniform  similarity,  that  when  one  has  seen 
one,  he  has  seen  the  whole.  The  old  cemetery  is  now  nearly 
full  of  such  vaults. 

In  a  part  of  the  burying  grounds,  there  is  a  portion  sepa- 
rately walled  off,  over  the  entrance  to  which  is  the  inscrip- 
tion, "  Creencias  Yarias,"  meaning,  "  dissenting  creeds." 
Here  one  finds  a  number  of  vaults  containing  the  bodies  of 
those  who,  wandering  to  this  remote  land  in  quest  of  fortune, 
have  found  a  tomb  instead.  On  reading  the  inscriptions, 
one  learns  that  these  unfortunates  have  wandered  hither  from 
almost  every  country  of  the  Protestant  North.  As  a  rule, 
Art  has  given  them  tombs  of  more  simplicity,  and  absent 
Friendship  places  fewer  votive  offerings  thereon  than  one 
finds  over  the  graves  of  their  Catholic  brethren.  Yet  for  the 
absent  wreath  and  cross,  Nature  has  made  amends,  in  replac- 
ing the  one,  by  the  trailing  passion  flower,  and  the  other,  by 
rearing  one  constructed  of  stars,  in  the  Southern  sky,  for  the 
Southern  Cross,  as  a  faithful  sentinel,  nightly  watches  their 
ashes. 

The  largest  sum  of  money  derived  from  any  source  is  that 
received  from  the  hospital  lottery.  This  mode  of  raising 
money,  which  would  awaken  scruples  with  many  of  us,  is  here 
regarded  as  strictly  legitimate.  Since  I  have  been  here  the 
hospital  has  received  the  proceeds  of  a  concert  in  which  there 
were  two  hundred  players  011  wind  instruments.  But  of  all 
the  means  of  amusement  whence  money  is  procured  for  hos- 
pital support,  the  most  famous  is  bull  fighting.  As  this  is  a 
national  entertainment  of  the  Spanish,  I  am  glad  to  be  able 
to  furnish  a  description  of  what  I  saw  of  it.  There  is  a 
special  amphitheater  here  for  this  diversion,  where  standing 
room,  plain  or  choice  seats  may  be  had,  according  as  the  vis- 
itor is  willing  to  pay.  The  central  arena  is  fenced  off  by  a 


20  STATE  MEDICAL  SOCIETY. 

barricade  from  the  spectators.  Though  this  barricade  is 
strong,  yet  a  few  weeks  prior  to  my  visit  a  bull  broke  it 
dowTii,  and  added  to  the  fete  by  tossing  some  of  the  spectators. 
From  two  to  five  thousand  persons  witness  the  fights.  An 
hour  or  two  before  the  spectacle  it  is  announced  by  a  number 
of  persons,  dressed  in  a  grotesque  style,  parading  the  streets 
with  dancing  and  shouting.  The  show  commences  with  music 
from  an  excellent  band,  among  whom  is  one  who  plays  upon 
an  instrument  of  aboriginal  origin.  This  instrument  resem- 
bles in  sound  that  of  the  wooden  pianist  on  Kearny  street, 
San  Francisco.  A  company  of  soldiers  are  drilled,  and  dis- 
play evidences  of  good  training.  In  one  act  there  is  an  in- 
tention to  represent  and  personate  a  party  rapidly  growing 
here  that  has  as  its  ultimate  purpose  the  union  of  the  five 
Central  American  States  into  one  confederation.  There  next 
follow  some  creditable  equestrian  feats.  One  rider  is  espe- 
cially a  favorite,  and  as  he  appears  your  neighbor  at  your  side 
is  sure  to  tell  you  that  he  is  the  best  rider  in  Central  Amer- 
ica. This  prelude  having  concluded,  the  fighters  of  the  bull, 
partly  on  foot  and  partly  on  horseback,  take  their  positions 
for  the  combat.  These  men  are  dressed  in  colors  calculated 
to  madden  the  animal.  All  being  ready,  the  gate  opens,  when 
to  the  sound  of  music  the  bull  is  ushered  into  the  midst  of 
his  persecutors.  He  is  first  teased,  enraged,  and  chased  by 
those  on  horse,  who  goad  and  annoy  him  in  every  possible 
way,  taking  care,  however,  not  to  seriously  wound  him.  This 
is  the  most  exciting  and  critical  period  of  the  show,  since  as 
soon  as  the  bull  is  well  maddened,  he  may  make  an  unex- 
pected dash  at  a  horseman,  and  throw  both  man  and  horse  to 
the  earth.  Whenever  the  bull  accomplishes  this  masterly 
feat,  he  follows  it  up  by  attacking  the  unhorsed  rider.  The 
first  time  I  witnessed  a  fight  this  occurred,  and  for  a  moment 
the  man  was  in  extreme  jeopardy;  yet  through  the  aid  of 


ANNUAL  ADDRESS.  21 


his  comrades  he  escaped,  being  more  fortunate  than  a  man 
who  two  weeks  prior  to  this  was  so  thrown  and  killed  hy  the 
bull  thrusting  his  horn  through  his  chest.  After  a  short  time 
of  chasing  and  teasing,  during  which  the  footmen  flung  red 
blankets  in  front  of  the  bull,  and  paper-winged  darts  which 
fixed  themselves  in  his  sides,  the  animal  became  tired,  and 
seemed  to  lose  his  spirit.  As  soon  as  he  gave  signs  of  this 
he  was  allowed  to  escape,  and  a  new  one  allowed  to  enter. 
After  a  half  dozen  bulls  are  thus  treated,  in  which,  as  a  rule, 
neither  man  nor  beast  is  much  hurt,  the  show  concludes  by  a 
bull  being  caught  and  haltered,  when  two  men  mount  his 
back  and  ride  him,  to  the  infinite  merriment  of  the  specta- 
tors. In  bull  lighting  as  practiced  here,  no  charge  can  be 
made  of  foul  play,  since  it  is  never  permitted  to  kill  the  ani- 
mal, though  that  privilege  is  conceded  to  him;  and  should 
the  latter  catastrophe  occur,  most  naturalists  would  agree  that 
the  great  law  of  evolution  would  not  be  violated,  since  there 

O  ' 

would  be  a  survived  of  the  fittest. 

From  Dr.  Yela's  annual  report  we  learn  that  of  the  five 
thousand  four  hundred  and  ninety  patients  treated  there  were 
but  sixty-three  who  had  had  tubercular  consumption,  and  of 

these  but  about  one-half  had  died.     A  striking;  difference 

& 

from  what  one  finds  in  England  or  in  the  United  States;  here 
deaths  from  tuberculosis  amount  to  less  than  eight  per  cent, 
of  all  deaths,  wrhile  in  the  North  a  large  proportion  of  deaths 
in  hospital  practice  is  from  consumption.  Guatemala  con- 
tains a  population  of  one  million  and  a  quarter  of  inhabi- 
tants. Nearly  half  of  these  are  Indians,  the  descendants  of 
the  aborigines  who  are  civilized.  The  remaining  population 
consists  of  Ladinos,  who  are  a  mixture  of  Spanish  and  In- 
dian, and,  besides  these,  a  small  number  of  foreigners  of  vari- 
oiis  nationalities.  Pulmonary  consumption  almost  never 
occurs  among  the  pure  blooded  Indians,  but  is  chiefly  found 
among  the  Ladinos. 


22  STATE  MEDICAL  SOCIETY. 

Goitre  is  of  common  occurrence,  being  seen  chiefly  among 
the  Indian  women.  As  there  is  a  prevalent  opinion  here 
that  the  cure  of  a  goitre  tends  to  develop  scrofula,  hence 
those  subject  to  it  seldom  apply  for  treatment.  Cretinism, 
closely  associated  with  goitre  elsewhere,  does  not  occur  here. 
The  prevalence  of  goitre  renders  this  a  good  place  to  test 
Chatin's  theory  in  regard  to  the  origin  of  this  disease.  Ac- 
cording to  him  there  is  an  absence  of  iodine  in  the  water, 
air  and  food  in  regions  where  the  disease  prevails,  and 
the  general  absence  of  the  disease  is  owing  to  the  fact  that 
the  most  of  the  world  is  daily  taking,  in  some  form,  a  small 
dose  of  iodine,  at  least  enough  to  retain  its  thyroid  glands 
in  decent  limits.  This  subject  is  treated  of  exhaustively  in 
Moleschott's  "  Circle  of  Life,"  and  the  reader  of  that  section 
is  surprised  at  the  vast  array  of  observations  which  the  last 
twenty-five  years  has  brought  in  support  of  this  theory. 

In  the  vicinity  of  Guatemala  there  is  a  small  colony  of 
lepers,  some  fifteen  in  number,  who  are  k^pt  apart  from  the 
remaining  population.  The  cases  are  found  among  Spaniards 
who  are  thought  to  be  descendants  of  the  Moors.  The  dis- 
ease consists  of  a  hypertrophy  of  the  skin  and  the  subjacent 
tissues,  which  finally  ulcerate  and  slough.  The  disease  is 
not  considered  to  be  contagious. 

Among  those  connected  with  the  surgical  service  of  the 
Civil  Hospital  Dr.  Monteiros  holds  leading  rank  for  learning 
and  for  ability  as  surgical  operator.  His  recent  return  from 
a  professional  tour  abroad  was  the  subject  of  special  com- 
ment by  the  daily  press,  as  well  as  the  occasion  of  an  ovation 
on  the  part  of  his  medical  brethren.  On  the  day  of  his  re- 
turn several  of  his  friends,  as  is  the  custom  here,  took  car- 
riages and  went  out  several  miles  to  meet  him.  '  The  ovation, 
however,  had  an  abrupt  and  melancholy  termination,  in  this: 
that  one  of  the  teams  ran  away  and  seriously  if  not  fatally 
injured  two  medical  students. 


A. \\r.\i,   AIHM;KS>.  23 


The  Practice  of  Medicine  is  better  fortified  here  against 
charlatanism  than  in  the  United  States.  No  one  can  practice 
unless  he  is  a  graduate  of  a  school  of  recognized  standing, 
and  then  if  that  school  he  a  foreign  one,  permission  to  prac- 
tice is  only  given  to  those  who  pass  a  satisfactory  public  ex- 
amination, and  present  a  thesis  written  in  Spanish,  the  whole 
costing  the  applicant  about  one  hundred  and  fifty  dollars.  In 
passing  along  the  streets  here  one  is  struck  with  the  almost 
total  absence  of  medical  signs;  and  even  if  one  is  seen,  it  is 
in  characters  so  small  as  to  be  illegible  at  a  short  distance. 

There  is  a  medical  school  here  that  was  founded  many  years 
ago.  It  is  located  in  a  picturesque  building,  one  story  high, 
and  contains  a  large  number  of  lecture  rooms,  among  which 
was  one  very  handsome  apartment,  for  use  on  public  occasions. 
In  the  dissecting  room -I  found  tables  much  like  those  to  be 
found  in  one  of  the  medical  schools  of  San  Francisco.  The 
number  of  the  tables,  as  well  as  the  receptacle  for  dissecting 
material,  seemed  quite  inadequate  to  the  wants  of  one  hun- 
dred students  who  are  in  attendance.  The  building  is  partly 
surrounded  by  a  botanical  garden,  which,  however,  contains 
more  ornamental  plants  than  those  used  in  medicine.  The 
museum  contains  an  excellent  collection  of  specimens  of  nat- 
ural history — better  than  one  would  find  in  connection  with 
any  medical  school  in  our  country.  So  much  however  cannot 
be  said  of  the  pathological  collection,  which  was  sadly  mea- 
ger. In  the  pathological  museum  one  finds  a  rare  example 
of  a  deformed  infant,  resemblhig  closely  that  of  Ritta  and 
Christina,  in  Buifon's  Museum,  Paris.  This  child  has  a 
double  head,  one  trunk,  four  arms,  and  four  legs.  Professor 
Meigs,  of  Philadelphia,  never  failed  in  his  course  of  lectures 
to  deliver  an  eloquent  discourse  on  the  Sardinian  monster,  in 
which  there  seemed  to  be  duality  of  mind  working  in  unison. 
The  exhibition  of  Ritta  and  Christina  brought  money  to  the 


24  STATE  MEDICAL  SOCIETY. 

parents;  but  tins  luckless  Guatemaltecan  died  at  birth,  and 
its  Indian  father,  believing  its  mother  to  be  a  witch,  aban- 
doned her. 

Before  admission  to  the  medical  school,  the  candidate  must 
pass  a  satisfactory  examination  in  the  common  branches  of 
education  ;  he  must  also  possess  some  knowledge  of  the 
French,  German,  and  English  languages.  A  knowledge  of 
Latin,  once  required  as  a  prerequisite,  has  been  dispensed 
with.  This  is  singular,  when  one  remembers  the  close  rela- 
tion existing  between  medical  literature  and  that  language; 
and  besides,  the  Spanish  is  the  most  direct  descendant  of  the 
old  Roman  tongue.  The  words  of  that  ancient  people,  as  a 
sacred  heirloom,  have  been  passed  from  lip  to  lip  across  the 
bosom  of  twenty  centuries,  and  in  many  cases  with  slight 
change,  except  that  in  their  transit  they  have  acquired  more 
precision  and  harmony.  So  close  is  the-  kindred  that  if  Livy 
and  Caesar  were  to  appear  in  this  picturesque  land  of  the 
Cordilleras,  they  might  readily  fancy  they  were  in  a  Roman 
colony. 

The  curriculum  of  study  here  embraces  the  same  subjects 
as  in  our  schools;  there  is,  however,  far  more  time  given  to 
natural  history  and  the  physical  sciences,  but  much  less  to 
pathology  and  practical  discipline.  The  curriculum  embraces 
six  years  of  about  ten  months  annual  study.  As  seen,  the 
time  of  study  exceeds  that  of  England,  France  or  Germany. 

As  before  said,  one  finds  two  different  climates  in  Guate- 
mala, the  one  of  the  coast  or-  low  lands,  which  is  intensely 
hot,  and  the  intermediate  high  lands,  in  the  midst  of  which 
the  Capital  is  located,  and  where  one  finds  a  mild  or  cool 
temperature;  and  these  physical  differences  lend  their  re- 
spective impress  to  disease,  engendering  fevers  of  extreme 
virulence  in  the  low  lands,  while  those  of  the  higher  plains 
have  a  milder  type.  An  approximate  notion  of  the  tempera- 


A.N.M   A  I.     AlHUiKSS.  25 


ture  of  tin-  high  lands  may  he  formed  from  the  following 
figures  taken  from  a  table  of  observations  made  by  Mr.  Mc- 
Nider,  during  his  stay  in  the  City  of  Guatemala: 

MORNTNC.        NOON.        KVKMNC. 

January 56°  68f  °  65° 

June 63fJ  73°  66|° 

Yearly    :i  verage 61  °  73"  67° 

Mr.  Hall,  resident  American  Minister,  tells  me  that  at 
midnight  lie  has  observed  the  thermometer  to  stand  as  low 
a>  fifty  decrees.  The  average  rainfall  for  the  year  is  tifty- 
tive  inches.  The  rain  commences  in  May  and  lasts  for  about 
six  months,  the  largest  fall  being  in  September.  Slight 
showers  occur  during  the  remaining  so-called  dry  months. 
During  my  stay,  which,  lasted  from  the  16th  of  January  un- 
til March  l(>th,  there  were  a  number  of  showers. 

Owing  to  the  nnhealthfnlness  of  the  coast,  wealthy  land 
owners  seldom  live  there;  in  fact,  their  visits  there  are  brief 
and  infrequent,  knowing,  as  well  they  do,  that  such  visit  is 
at  the  risk  of  life.  On  the  contrary,  they  spend  the  most  of 
the  time  in  Guatemala  City.  During  my  stay  in  the  city, 
Mr.  Ramon  Aguirre,  one  of  the  prominent  men  of  the  place, 
found  it  necessary  to  visit  the  coffee  region  adjacent  to 
Champerico.  On  his  arrival  there  he  was  attacked  with  per- 
nicious malarial  fever,  and  died  in  four  days.  This  fever,' 
evidently  of  miasmatic  origin,  is  called  here  amariHo  or  yel- 
low fever.  The  person  attacked  vomits  violently,  becomes 
intensely  yellow,  and  as  a  rule,  soon  dies.  These  are  the 
characteristic  features  of  our  Southern  yellow  fever,  but  as 
the  disease  is  not  contagious,  and  is  often  curable  by  large 
doses  of  quinine,  physicians  here  do  not  regard  it  as  identical 
with  hlack  vomit,  or  yellow  fever.  The  experienced  physi- 
cians of  this  country  claim  that  they  can  nearly  always  cure 
the  disease  here,  if  they  are  called  in  time.  Sometimes, 
however,  the  attack  falls  with  such  fulminating  violence  that 


STATK   MKWCA.L  SOCIETY. 


no  remedy  can  stay  it.  Such  was  the  case  of  Aguirre,  who 
died,  though  he  had  skilled  medical  service  constantly  at  his 
side.  Those  persons  whose  business  compels  them  to  pa>s 
much  time  on  the  coast,  as  a  rule,  find  immunity  from  dis- 
ease by  constantly  using  quinine.  For  this  purpose,  from 
eight  to  ten  grains  daily,  should  be  taken. 

The  traveler  here  soon  learns  to  duly  appreciate  the  value 
of  cinchona.  Take  away  its  alkaloid  extract,  quinine,  and  in 
less  than  two  generations  the  low  lands  of  Central  America 
would  relapse  to  barbarism;  without  this  precious  safeguard, 
steamship  lines  would  never  have  been  established  here,  nor 
would  Northern  engineers  have  been  able  to  penetrate  the 

tangled  fastnesses  of  the  dense  woods,  to   survey  routes  for 

o  «/ 

railroads.  Hence  medicine,  in  the  discovery  of  the  virtues 
of  Peruvian  bark,  has  contributed  the  most  potent  factor 
towards  the  advancement  of  civilization  in  these  regions 
where  nature  so  stoutly  resists  its  progress.  Humboldt,  in 
his  "  Ansichten  der  Natur,"  shows  that  this  discovery  is 
wholly  due  to  our  profession;  for  instead  of  its  being  an 
aboriginal  remedy,  he  found  in  his  travels  among  the  Andes 
that  the  Indians,  when  attacked  with  fever,  could  not  be 
persuaded  to  take  this  Peruvian  bark. 

As  epidemic  diseases,  cholera  and  small  -pox  occasionally 
present  themselves  in  Guatemala.  In  a  village  not  far  from 
.the  Capital,  a  few  years  ago,  there  was  an  invasion  of  cholera. 
As  such  a  thing  had  hithertoo  been  unknown  its  appearance 
on  this  occasion  was  attributed  to  the  foreigners  having 
poisoned  the  water,  and  this  belief  took  such  strong  hold  of 
the  native  mind  that  several  of  the  foreigners  deemed  it  pru- 
dent to  leave  the  place  for  a  time.  Small-pox,  during  my 
visit,  wa.s  prevailing  epidemically  in  some  of  the  northern 
villages,  yet  owing  to  the  medical  profession  encouraging 
vaccination,  and  likewise  to  the  assistance  rendered  by  the 


ANM  A i,   AmuiKss.  27 


<io\  eminent  in  tin-  same  direction,  the  disease  \vas  arrested. 
The  advantages  of  vaccination  have  received  further  proof 
and  illustration  in  this  country.  Among  the  Indians  it  is 
difficult  to  accomplish  vaccination,  the  same  prejudice  exist- 
ing among  them  concerning  it  as  one  finds  in  certain  places 
further  north;  hence  where  small-po\  appears  among  the  In- 
dians it  is  very  fatal,  while  the  most  of  foreigners  who  have 
been  vaccinated  escape  the  disease.  ,  Still,  despite  these  plain  ,* 
facts,  which  are  in  accord  with  European  and  Jlerfican  e^firTrt 
perience,  one  iinds  in  all  parts  of  the  world  a  few  minds  who 
will  not  accept  them.  As  instances  of  such  recalcitrant  minds 
are  1 1  am  men  i  jk  of  Vienna  and  Guerin  of  Paris.  The  former 
headed  a  deputation  a  few  years  ago  that  petitioned  for  the 
abolition  of  compulsory  vaccination,  while  to-day  the  French 
Academy  of  Medicine  often  hears  a  harangue  from  Gnerin 
against  vaccination;  and,  true  to  his  convictions,  I  saw  that 
Guerin  did  not  isolate  small-pox  patients  from  others  in  his 
wards,  showing  an  indifference  as  though  he  thought  that  the 
disease  was  non-contagious.  As  analogues  to  these  malcon- 
tents are  those  who  claim  that  Shakespeare  did  not  write  his 
plays,  who  deny  that  Newton  discovered  the  law  of  gravita- 
tion, or  Harvey  the  circulation  of  the  blood,  or  Columbus 
America.  Such  men  would  fain  steer  against  the  irresistible 
stream  of  truth,  and  hope  to  gain  notoriety  from  the  conse- 
quent wreck  of  their  puny  barks.  Latin  America,  notwith- 
standing its  intense  devotion  to  orthodox  medicine,  has  re- 
cently been  favored  with  the  advent  of  such  an  illy  com- 
pounded genius,  who  indulges  his  pen  in  occasional  diatribes 
against  vaccination,  and  advises  as  a  preventive  to  take  ho- 
meopathically  prepared  pillets  of  vaciiiia.  Instead  of  going 
with  the  Yicar  of  Wakefield  across  lots  to  the  church  he 
would,  with  the  Vicar's  wife  reach  thither  by  a  road  three 
miles  around — that  is,  on  his  wall-eyed  iniinitessimal  colt 


28  STATE  MEDICAL   SOCIETY. 

he  would  reach  the  blood  through  the  circuitous  route  of  the 
stomach  and  bowels.  Those  who  accept  Hahnemann's  sacred 
Trilogy,  that  all  existing  disease  originated  in  itch,  barber's 
itch  or  syphilis,  will  probably  not  find  it  hard  to  believe  that 
the  vaccine  germs  which  are  launched  on  tin's  eventful  pil- 
primage  down  their  throats  will  be  lucky  enough  to  find  a 
point  at  which  they  can  debark  somewhere  along  the  winding 
shores  of  the  alimentary  canal. 

Some  years  ago  there  was  erected  in  the  City  of  Guate- 
mala a  monument  to  commemorate  Jenner's  discovery  of  vac- 
cination. Is  it  not  an  opprobrium  to  the  north  that  only  in 
this  remote  corner  of  the  earth  has  there  been  just  recogni- 
tion of  this  great  discovery. 

A  singular  fact,  and  which  has  been  the  subject  of  much 
study  by  Dr.  Stoll,  a  very  intelligent  physician  of  Guate- 
mala, is  that  the  art  of  mesmerism  is  known  and  practiced 
by  the  Indians  of  G-uatemala.  Dr.  Stoll  is  preparing  a  work 
upon  one  of  the  Indian  races  here,  in  which  this  subject  will 
be  thoroughly  treated  of.  This  is  another  fact  to  be  added 
to  those  which  Figuier  has  collected  in  his  "-  History  of  the 
Marvelous,"  in  which  it  is  shown  that  sorcery,  witchcraft, 
sonnambulism,  hypnotism,  table-rapping  and  mesmerism  are 
branches  of  one  common  tree,  in  the  trunk  of  which  are 
bound  up  all  the  races  of  humanity. 

Among  Americans  who  deserve  special  mention  in  connec- 
tion with  the  west  coast  of  Central  America,  is  Captain  J. 
M.  Dow.  This  gentleman,  now  agent  of  the  Pacific  Mail 
Steamship  Company,  at  Panama,  about  1856  commanded  the 
Columbus,  a  small  steamer  that  made  monthly  voyages  along 
the  coast,  stopping  at  the  leading  ports.  Through  the  intel- 
ligence and  industry  of  Captain  Dow,  commercial  relations 
were  inaugurated  with  these  States,  which,  small  at  first,  have 
grown  to  large  proportions,  and  have  been  the  means  of  giv- 
ing to  the  Ilunited  States  those .  advantages  which  England 


ANNUAL  ADDRESS.  29 


lias  had  the  shrewdness  to  grasp  and  monopolize  on  the  west 
coast  of  South  America.  As  an  example  of  the  development 
of  trade,  may  be  mentioned  that  in  the  commencement  the 
yearly  amount  of  coffee  exported  from  Guatemala  was  but 
thirty  thousand  sacks;  now  there  are  annually  shipped  three 
hundred  thousand  sacks.  Besides  his  services  to  commerce, 
Captain  Dow  has  made  valuable  contributions  to  natural 
science  in  the  discovery  of  new  species  of  plants,  fishes,  and 
animals.  As  an  addition  to  botany,  he  has  discovered  in 
Costa  Rica  one  of  the  most  beautiful  orchids  of  tropical 
America,  which  has  been  named  after  him  by  foreign  scien- 
tific authorities.  In  the  Gulf  of  Fonseca  he  has  found  a  fish 
having  four  eyes,  and  which  is  viviparous ;  and  finally,  he  has 
found  a  species  of  tapir  previously  unknown.  Such  work  on 
the  part  of  one  so  busily  occupied  with  other  matters  so  for- 
eign to  scientific  pursuits,  is  in  the  highest  degree  praise- 
worthy. His  work  has  been  duly  recognized  both  at  home 
and  abroad.  In  England,  where  proper  caution  is  exercised 
in  awards  to  merit,  he  has  been  admitted  to  membership  of 
one  or  more  of  the  learned  societies. 

This  article  would  be  incomplete  without  special  mention 
of  Dr.  Fenner,  who  came  from  New  Orleans  to  Guatemala  a 
few  years  since,  and  through  his  high  attainments  in  medi- 
cine has  reached  the  first  position  in  his  profession.  Besides 
being  the  consultant  usually  asked  for  where  especial  skill  is 
required,  Dr.  Fenner  has  had  the  rare  fortune  to  reach  a  near 
place  to  the  government,  so  that  no  one  is  on  more  intimate 
terms  than  he  with  General  Barrios — that  remarkable  man 
whose  fearless  heart,  upright  character,  and  unfaltering  pat- 
riotism have  safely  conducted  Guatemala  through  so  many 
perils,  and  at  this  hour  are  causing  most  eyes  to  turn  towards 
him  as  the  one  most  competent  to  rule,  in  the  event  of  these 
five  republics  entering  into  one  common  union. 


AN  INITIAL  PINE  OP  25  CENTS 


Photomount 
Pamphlet 

Binder 
Gaylord  Bros. 

Makers 
Syracuse,  N.  Y. 

PAT.  JAN  21,  1908 


YC   14891 


570356 


UNIVERSITY  OF  CALIFORNIA  LIBRARY 


